Evolving environment or break of balance?

Children and adolescents are living in a world affected by continuous transitions. A phenomenon with a double meaning: it implies a life of change in a constantly evolving environment, as well as a possible a break of balance: a loss of equilibrium. Transition, the leading theme of the ESCAP 2017 Congress, contains many aspects that are relevant to youth mental health.

A first important issue is transition on a socio-cultural level. Children and adolescents are experiencing contemporary changes such as migration and globalization. For many children these changes have developed dramatically in the last decade – Europe is now being confronted with the turmoil in Syria, North Africa and other parts of the world, with the daily reality of the refugee crisis visible in its backyard. Mental health professionals and many other care providers are facing the end of the safe haven and are up against a long-term challenge, the scope and dimension of which are unknown. Professionals are called to offer care devices and psychotherapeutic approaches that allow this vulnerable population to overcome these difficulties, by redefining the changes to prevent serious breakdown. “We take the role of providing evidence-based knowledge and guidance to refugee helpers. This should and will be the role of ESCAP in this situation, where many children have to live through such radical experiences”, says professor Dimitris Anagnostopoulos (Athens, Greece), board member of ESCAP and in charge of the ESCAP refugee project, ‘ESCAP for mental health of child and adolescent refugees’. Professor Anagnostopoulos and his team will be giving a keynote lecture on this subject at the Geneva congress.

Organizational aspectsAnother focus of the ESCAP Congress in Geneva was transition in terms of systems of child and adolescent mental health care. Outcomes of new research has added to the congress attendees’ understanding of the development of child and adolescent psychiatric disorders, influenced by the many current dynamics. Various lecturers will discuss ways in which mental health systems could adapt to changing circumstances and underline the growing importance of professional changes such as early intervention.“A new approach is necessary”, according to professor Patrick McGorry (Australia), keynote speaker at ESCAP 2017. “Young people do not often contact or look for support with the existing care and support services and organizations. This raises concerns and questions about the accessibility and appropriateness of the support and care offered, in particular for young people with mental health problems which could have a long-term impact.” McGorry has advocated lowering the threshold of care with an approach that enters the daily environment of young people and actively involves them in ‘their’ mental health issues. McGorry: “Cross-sectoral cooperation based on what young people with mental health issues need in order to fully participate in education or work should be the key principle in this approach, meaning cooperation between schools, labour market agencies, employers, social- and youth work and health care providers.”

Affordable care“Consequently, mental health professionals are challenged to support their patients at different stages of their lives and in different contexts, such as family life, at school and in their peer groups. The purpose will have to be: offering affordable care services, so that, where there is a change, care can continually be assured”, says professor Stephan Eliez, president of ESCAP and chair of the ESCAP 2017 programme committee.

Cross-disciplinary collaborationThis connected the congress theme to the urgency of collaboration. The transition of patients from youth psychiatry to other medical disciplines – such as paediatrics – and child and adolescent psychology has gradually become a professional routine in European youth mental health care. Many psychologists were welcomed in child and adolescent psychiatry; psychotherapeutic approaches are gaining ground in treatment programmes and psychological research has shown to be very worthwhile. The Geneva congress has explored these topics more in-depth and also intends to examine the collaboration with allied, non-medical disciplines, such as: speech therapy, ergo therapy, moto therapy, et cetera. The congress programme intends to present models for joining forces and performing research jointly to increase an evidence base for combined treatments. “This will inevitably make the pendulum swing back to clinical psychiatry. Child psychiatrists will be forced to take a critical look at themselves”, says ESCAP board member and head of research, Johannes Hebebrand (Germany). “For traditional child psychiatrists this might be one of the toughest transitions. We have known for a long time that psychiatric disorders are indeed complex with no easy fix or solution or therapy. We now need a transition into stratified approaches which go beyond the relatively simple diagnostic categories.”

Programme scopeThe ESCAP 2017 programme committee has shown courage and ambition by attacking a congress theme as broad and deep as ‘Transition’. Dr Hélène Beutler, member of the programme team and co-president of the hosting Swiss Association for Child and Adolescent Psychiatry (SSPPEA/SGKJPP), says: “So many delegates were pleased with the scope of the 2015 congress programme in Madrid. There was something for everybody. For the congress in Switzerland we will be pursuing the same course. Hopefully this congress has allowed clinicians and researchers, psychiatrists in independent practices and those who are committed to institutions to find the answers that will enhance their daily involvement with children and adolescents with mental disorders. The experience of multi-dynamic change unites us – transition must be on everyone’s mind.”

The long-term effects of bullying

Dieter Wolke.

Bullying has underestimated long-term effects into adulthood on depression, anxiety disorder, increased self-harm, increased suicide, and psychotic symptoms.Professor Dieter Wolke (University of Warwick, UK) reveals the huge impact that bullying by peers and siblings can have on children's mental health. He has performed a keynote lecture at the ESCAP 2017 conference in Geneva. Read the interviewin English, en français, auf Deutsch.

KEYNOTE AT ESCAP 2017

Mood problems in young people

Patrick Luyten.

Professor Patrick Luyten (Leuven, London), keynote speaker at the 2017 ESCAP Congress in Geneva, pleads for a more person-centred approach of mood problems in young people, a greater focus on developmental factors and underlying vulnerability, and less parent blaming. Read the interview.

KEYNOTE AT ESCAP 2017

Adolescents' access to care

Patrick McGorry.

“Imagine if people with cancer or heart disease were told: ‘It’s not serious enough, come back later when it is worse’. We are talking about a massive double standard here between mental illness and somatic illness.”Professor Patrick McGorry (Australia) on the access of young people to mental health services. Adolescents with mental health problems often meet the care system at its weakest. In English, en français, auf Deutsch.

KEYNOTE AT ESCAP 2017

Growing up poor: a high-risk transition

Maria Melchior.

Inequality is related to the onset of mental health problems, confirms Maria Melchior (Paris). Melchior was the opening keynote lecturer at the ESCAP 2017 Congress about Social inequalities in children’s mental health. Read the interview in English, French or German and learn about her answers to the high risks of low socioeconomic status (SES).

KEYNOTE AT ESCAP 2017

Reducing autism by early intervention

Tony Charman.

Professor Tony Charman (King’s College London) says he aims “to make differences between trajectories and try to divert children from a pathway where they would possibly go on to develop autism, to a more typical outcome”. As a keynote speaker at the ESCAP 2017 Congress, Charman has presented his “very promising” study on the effects of early intervention on reducing autism. Available in English, French or German.

Subscribe to the ESCAP News Alert

Subscribers to the ESCAP News Alert service will receive our updates on child and adolescent mental health issues and event news. Note that ESCAP carries no conflicts of interest – we never send commercial messages.